Provider Demographics
NPI:1508571431
Name:PITTMAN, FERN EVA MARIE (CRNP)
Entity Type:Individual
Prefix:
First Name:FERN
Middle Name:EVA MARIE
Last Name:PITTMAN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:FERN
Other - Middle Name:EVA MARIE
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1537 PRINCESS ANNE DR
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-5628
Mailing Address - Country:US
Mailing Address - Phone:717-925-4132
Mailing Address - Fax:
Practice Address - Street 1:111 S FRONT ST
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17101-2010
Practice Address - Country:US
Practice Address - Phone:717-782-5256
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-16
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP026702363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily